Provider Demographics
NPI:1649043258
Name:LINK, MANON (CLS)
Entity type:Individual
Prefix:
First Name:MANON
Middle Name:
Last Name:LINK
Suffix:
Gender:F
Credentials:CLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2421 CASTLEBAR DR APT 203
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-1570
Mailing Address - Country:US
Mailing Address - Phone:256-746-7013
Mailing Address - Fax:
Practice Address - Street 1:2421 CASTLEBAR DR APT 203
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-1570
Practice Address - Country:US
Practice Address - Phone:256-746-7013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN